HomeMy WebLinkAboutPermit Mechanical 2000-04-28SPRIIVGFIELD
Job# 00-00624-01
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Page 1 of 2
IRANSS:01-0001400
DATE:APR T8 2OOO
Al'lT REID:Z $ 26.50
CHANEE:
CASHiER:05?
225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 4010 E 00016th Ave Spr
AssessorsMap#: 17033443
Lot: Block: Addition
Job Number: 00-00624-01
Office:726-3759
lnspection Line: 726-3769
Tax Lot#: 06600
Subdivision:
ctrY oF SPRINGFIELD, OREGOI'
Owner: David Carvo
Address: 1430 Willamette
Scope Of Work: Mechanical
Phone Number:
City/State/Zip:
Alteration
503-267-1 878
Eugene, OR 97401
Value: $O
cl)
t"-
Z.
9,
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
To request an inspection call the 24 hour
a.m. will be made the same working day,
working day.
record
o.Co ings:
Group:
7:00
lowing
oe
'=
I
CN L
=
()
@
Rough Gas
Gas Service
FinalGas
Gonstruction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access?
Area (Sq
Main:Accessory:
-OO"r line is installed and line has
-When allgas work is complete.
a.been connected to alr
l-<.4 )>.
8r,6 appliance. Pressure te:
I
.E
# Of Stories: Height (feet):
Current Units: Proposed Units:
Census Code: Does not apply
Total:
Fee Paid On Receipt# Value/Quantity Fee Amount
Mechanical
One to Four Outlets
Minimum Mechanical Permit
Mechanical Administrative Fee
Mechanical lssuance
0412812000
0412812000
04128t2000
04128t2000
1400
1400
1400
1400
$2.00
$13.00
$.4s
$10.00
All inspections
after 7:00 a.m. will
:
1
Job# 00-00624-01 Page 2 of 2
Fee Paid On Receipt# Value/Quantity Fee Amount
Mechanical
State Surcharge For Mechanical Permit
Total Mechanical
0412812000 1400 $1.0s
$26.50
Grand Total
By signature, I state and agree that I have carefully examined the completed application and do
hereby certify that all information herein is true and correct, and I further certify that any and all work
performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of
the State of I further state that only contractors and employees who are in compliance with
oRS 701.055 be used on this project. I further agree to ensure that all required inspections are
req per ti the project address is readable from the street.
re
$26.s0
-